Why Pillars of Health matters
The EU internal market brings many benefits, such as freedom of movement, including for health workers. However, in the European health labour market, we see that the excessive and asymmetric migration flows of health workers contributes to an unequal geographic distribution of health workers, which mainly benefits the more affluent countries in the EU (‘destination countries’). This has not helped solve the compromised access to skilled and motivated health workers for citizens in the less affluent countries (‘source countries’).
For example, Romania and Serbia are known as ‘source countries’ that struggle with excessive health worker outmigration, which affects their health systems. In addition, for Serbia, a country in the process of joining the EU, it is essential to plan strategies that prevent the anticipated mass outmigration of their health workers to other EU countries as a result of joining the EU single labour market. Germany and France, on the other hand, are known as ‘destination countries’ and benefit from health worker migration from the ‘source countries’. The maldistribution of health workers has significantly impacted the health systems resilience and the health of the populations of the affected countries. This is against the spirit of the so-called ‘upward convergence’, which is a central principle in the EU. It means improving the economic and social performance of EU Member States, while also reducing disparities between countries.
We believe that public health and human rights defenders need a platform to coordinate (joint) efforts, to support them in understanding and reversing the negative effects of excessive health worker migration and mobility. The Pillars of Health coalition aims to serve as such a platform, by sharing research and evidence on health worker migration and mobility, and by using these as the basis for our joint advocacy. This way, the coalition can also contribute to maintaining and strengthening the EU’s core principles: solidarity and joint prosperity.
Addressing health worker mobility at three interlinked levels
We believe health worker mobility must be addressed at three interlinked ‘levels’: source countries, EU-level, and destination countries. Each of these are affected differently by (excessive) health worker migration. Change on each level is needed to achieve equal access to health workers for all European citizens:
Source countries should be able to invest in health workforce planning, development and retention, and to mitigate push and pull factors behind health worker migration and mobility (such as salaries, working conditions, and career prospects).
Destination countries should not depend on foreign recruitment, but strive for self-reliance by implementing solutions that are more sustainable than recruiting health workers from abroad.
Based on monitoring of the health work labour market, mobility and migration trends, the EU should stimulate health systems strengthening and cross-country learning and progress to reduce health inequalities arising from labour market dynamics.
Advocating equal rights and opportunities for health workers
The abovementioned steps on each level should contribute to better working conditions for health workers in the EU. We believe their needs should always be taken into account at the three interlinked levels. We therefore advocate that all health workers should have equal rights and opportunities both in source and destination countries, and be able to move freely. They should enjoy optimal working conditions, be safe and secure, earn adequate wages, have opportunities for continuous professional development and career prospects. This will increase work satisfaction and retention in their countries of origin. Those in destination countries should enjoy equal opportunities as their local counterparts.